The Center for Clinical Quality Evaluation (CCQE), in conjunction with the American Health Quality Association (AHQA), Midwest Business Group on Health (MBGH), and the National Business Coalition on Health (NBCH), proposes to convene a Follow-up Invitational Workshop of Community-based Quality Improvement by bringing together leaders and purchasers of health care. The initial workshop, held in January 1997, provided the beginning structure for sharing successful improvement strategies and encouraged future collaboration. These activities have continued, with some being more successful than others. Attendees will be asked to share their experiences in pre-workshop surveys and in case study presentations during the workshop. With the emphasis on improving health care across populations, this workshop will explore how these collaborative efforts achieved success and what can be learned from the ten participating states. To facilitate learning from the experiences in these states, a workbook will be drafted by workshop participants, for use by organizations interested in community-based quality improvement. The "draft workbook" will be put into final form by a professional health writer for use by attendees and others in quality improvement organizations and purchasers of health care. These goals will be met through a one and a half-day workshop that will include the following activities: * Use of a facilitator who understands and has experience working with both quality improvement organizations and purchasers of health care; * Presentation of case studies initiated and the result of the last workshop; * Small group work, matching attendees from each state, to discuss informally barriers and successes which would be important to include in the workbook; and * Discussion by all attendees of progress made during the small group work to define the broader quality improvement issues.